Category: Conditions

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You’re Still You: Resources for Recovery from Domestic Violence

Domestic violence is more complicated than it sounds. Until you’re in the thick of it, you might imagine the lines are clearly drawn. “If it ever gets physical, I’ll leave right away.” But then it happens on a holiday, or while you’re between jobs. It happens in private, and you can’t remember all the details. So you tell yourself it wasn’t as bad as it felt. Or, it could have been worse. Or, it didn’t really happen at all.

Here’s the thing: it doesn’t matter how bad it is. You don’t get a prize for withstanding more abuse. By the time you’re wondering if you need support, you probably do. That means different things for different people. Maybe it’s time to text a friend and ask them to have coffee. If things are more serious, you can call a hotline or find a shelter. And once you meet your basic needs for safety, you might consider rehab that treats domestic violence survivors.

Immediate Help

If you’re in a violent relationship, you can get immediate support. These hotlines and resources can help you make urgent decisions and get to safety.

Recognizing Abuse

You might not be sure if a relationship is abusive. Maybe the aggressor’s actions seem justified. And if you can empathize with someone, it’s hard to think of them as an abuser. But at the end of the day, even if you understand their motivations, violence is never acceptable. Look for these signs to recognize domestic abuse:

  • Physical violence against you, your pets, your home, or your belongings
  • The threat of physical violence, whether or not it’s carried out
  • Intimidating you physically, verbally, or with weapons
  • Verbal insults, humiliation, or threats
  • Controlling behavior, such as telling you what you can and can’t wear, or setting a curfew for an adult partner
  • Isolating you from family or friends, or discouraging you from getting social support
  • Taking control of your finances
  • Sexual assault, or pressuring you to perform sexual acts
  • Pressuring you to use drugs or alcohol

Cultural norms can make it hard to admit that abuse is happening at all. In the media, domestic violence usually takes place in heterosexual relationships, with a man as the aggressor. And it almost always includes a physical attack. But in reality, abuse can be much more complicated.

Domestic violence can happen within any close relationship: between partners, parents and children, or even platonic friends. And it can happen to anyone, including men, CEOs, and people with other types of privilege. Your identity doesn’t protect you from being abused—and it doesn’t have to stop you from getting help.

Violence Against Men

Approximately 25% of women and 14% of men experience domestic violence1 from a partner. While women are at a higher risk, men are still vulnerable to this dynamic. And the stereotype that men can’t be abused2 may prevent them from getting support.

One study interviewed staff members at an organization that supports male abuse survivors. A service manager for their hotline described a typical conversation with a new client. “I have guys that call me and say ‘I can’t be a victim of domestic abuse…I am a police officer, I’m a judge, I’m a solicitor, I work in the field, I can’t be a victim.’ Even though they know what is going on.”

This reluctance is so common, there’s a word for it. Denial, or minimization, is a common response to trauma.3 It may come from the abuser, who tries to convince you they did nothing wrong. Or it might feel like a way to protect yourself from your own feelings about their abuse. But denial can be invalidating. And no matter who you are, or how society views you, you deserve to be healthy and safe.

Abuse in LGBTQ+ Relationships

Stereotypes can also make it hard to acknowledge abuse between people of the same gender. The narrative that “men can’t be abused and women can’t be abusers” hurts everyone—even LGBTQ+ people. And the numbers make it clear that abuse goes beyond gender or sexuality. In fact, bisexual people are at greater risk for domestic violence4 than either gay or straight people.

Even in healthy LGBTQ+ relationships, stigma can prevent you from getting social support.5 And if your partnership gets violent, it gets even harder. LGBTQ+ abuse survivors face unique barriers6 to social services, treatment, and other resources.

There are several reasons for this. First, not all clinicians are experienced in LGBTQ+ issues. And when you’re in crisis, the last thing you want to do is spend time educating a therapist. Some clients might even be afraid to come out to their provider. If that’s your experience, you can connect with an LGBTQ+ affirming program to get effective support.

Abuse and Addiction

Drug and alcohol use complicate any relationship. That’s true whether it’s healthy, abusive, or somewhere in between. You might go out drinking with coworkers, and end up kissing your work crush for the first time. Or, you might stay in a violent relationship because it’s the only way you can access cocaine. These are extreme examples, but they’re both on the same spectrum.

Coercion is common in abusive relationships.7 In that dynamic, one person convinces the other to do things they don’t really want to do. This reinforces the imbalance of power. It can also make you feel ashamed of your own actions. And if they’re coercing you to take drugs or drink excessively, there’s a direct impact on your mental health. Drug use can stop you from thinking clearly, so it’s impossible to make an escape plan. It can also dull your emotions and interfere with your memory, so you have a harder time proving there was abuse in the first place.

Trauma Bonding

Drug abuse increases the risk of domestic violence.8 These two patterns also follow a similar rhythm. The high of being on drugs is often followed by the crash of a hangover. The same thing happens in abusive relationships—the good times are the very best, and the bad times are awful. In some relationships, there’s little in between.

This cycle can lead to traumatic bonding.9 Here’s how that works:

  1. You develop a close, trusting relationship with another person. You come to rely on them for emotional support.
  2. They commit an act of violence against you.
  3. You feel hurt, and instinctively seek comfort.
  4. Because you’re close to your abuser, you turn to them. If they’re also isolating you from friends and family, you may not have anyone else to talk to.
  5. They either provide or withhold emotional support. Either way, this reinforces the power dynamic, reminding you how much you need them.

The experts at All Points North Lodge say that trauma bonds feel a lot like addiction.10 So whether or not you’re actually taking drugs, residential rehab might be the right place to start healing.

Long-Term Recovery From Abuse

When it’s time to leave an abusive relationship, you’ll have some urgent priorities. And your long-term mental health might not be one of them. That’s okay. Start by securing a place to live, an income stream, and other basic necessities. You can plan your emotional recovery when you’re ready. At that point, you’ll have several options.

Trauma-Informed Care

Trauma-informed care is a general style of treatment, not a specific type of therapy. It’s often helpful for people with specific diagnoses, like post-traumatic stress disorder (PTSD) or complex PTSD (c-PTSD). It can also treat more general symptoms of trauma, as well as addiction and other mental health issues.

In this approach, providers use certain tactics to make recovery accessible. For example, if you get triggered during a therapy session, they’ll know how to respond. Trauma-informed care honors you as the authority on your own experience.

According to experts in domestic violence, a trauma-informed therapist “views individuals as survivors11 rather than victims, and recognizes symptoms as adaptive responses.” In other words, the symptoms of trauma serve a purpose. Or, they did while you were in a dangerous situation. Once you get to a safe place, those same behaviors might get in the way of your mental health. Treatment empowers you to recognize when those responses are and aren’t helpful. You’ll also learn more sustainable coping strategies.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) takes a practical approach to recovery. As a behavioral treatment, it puts you in the driver’s seat. Instead of focusing on how you feel, it teaches you new ways to respond to your feelings. And changing the way you act can improve your life and relationships. In time, you’ll feel better because of your ongoing behavior. CBT is a popular treatment for survivors of partner violence.12

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) uses physical stimuli to help you work through traumatic memories. Usually, patients describe those memories in detail during a therapy session. By performing certain eye movements, they become desensitized to triggers. But EMDR for domestic violence survivors can look a little different.13 You won’t always recount past memories during a therapy session. Instead, you might focus on mindfulness techniques and free association.

Cognitive Processing Therapy

Cognitive processing therapy (CPT) was first developed to treat survivors of sexual assault.14 It can also help you heal from other types of intimate violence, like verbal and physical attacks. Unlike CBT, this approach delves into your deepest thoughts and feelings about your trauma.

After intimate violence, many survivors have a sense of cognitive dissonance. For instance, you might blame yourself for someone else’s actions. But at the same time, you may feel like you had no power in the situation. It’s often hard to reconcile your sense of self with the reality of abuse. CPT helps patients make peace with that paradox.

Find Yourself Through Recovery

Trauma changes you. Maybe you lost a period of time, or a relationship you cared about. It can even seem like you lost yourself.  And the process of recovery can feel a lot like grief.

There’s no simple solution here. But with the right support, there is a way forward. Over time, you can get to know yourself again, and build the beautiful life you deserve.

Connect with a trauma-specialized rehab to learn about their housing options, pricing, and treatments.

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Exploring the Link Between ADHD and Addiction

Attention-deficit/hyperactivity disorder (ADHD) is a serious mental health issue. From the name, it’s easy to think this condition is a set of behavioral problems. But those are just the symptoms. In reality, ADHD comes from a neurochemical imbalance—and it’s remarkably similar to the brain chemistry of addiction.

If you’re considering treatment for ADHD and addiction, you can start by learning how they relate to each other.

The Brain Chemistry of Addiction and ADHD

People with ADHD have much a higher risk of addiction. ((Davis, Caroline, et al. “Attention-Deficit/Hyperactivity Disorder in Relation to Addictive Behaviors: A Moderated-Mediation Analysis of Personality-Risk Factors and Sex.” Frontiers in Psychiatry, vol. 6, Apr. 2015, p. 47. PubMed Central, https://doi.org/10.3389/fpsyt.2015.00047.)) This is true across age groups, affecting both adults and teens with ADHD. ((Schellekens, Arnt F. A., et al. “Often Overlooked and Ignored, but Do Not Underestimate Its Relevance: ADHD in Addiction – Addiction in ADHD.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 169–72. www.karger.com, https://doi.org/10.1159/000509267.)) Experts agree that the 2 conditions have “a shared biological background.” Specifically, both addiction and ADHD have an impact on dopamine, which is a neurotransmitter.

Dopamine relates to the brain’s reward system. ((Watson, Stephanie. “Dopamine: The Pathway to Pleasure.” Harvard Health, 20 July 2021, https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure.)) This naturally occurring chemical is released when you do something pleasurable. The brain defines “pleasure” broadly: your dopamine might increase when you buy a new pair of shoes, get a job, or eat a cookie. And when an activity feels good, you’re more likely to do it again.

That can be very healthy. For example, you can get dopamine from exercise. ((“Five Surprising Ways Exercise Changes Your Brain.” Greater Good, https://greatergood.berkeley.edu/article/item/five_surprising_ways_exercise_changes_your_brain. Accessed 14 Dec. 2022.)) Your brain is quite literally wired to make you want to work out. But there’s a downside to dopamine. Plenty of activities—like substance use—feel good while doing serious damage to your health. And for people with ADHD, dopamine might already be hard to come by.

The Biology of ADHD

If you have ADHD, it may take extra effort to concentrate, sit still, or complete important tasks. This often interferes with relationships, schoolwork and career. In severe cases, people with ADHD can qualify for disability benefits. ((Is ADHD A Disability? https://www.disability-benefits-help.org/disabling-conditions/adhd-and-social-security-disability. Accessed 14 Dec. 2022.)) But it also comes with some advantages. Like any other type of neurodivergence, this condition changes the way you see the world. And your unique insight can be a strength.

Biologically, people with ADHD can’t regulate dopamine levels. ((Blum, Kenneth, et al. “Attention-Deficit-Hyperactivity Disorder and Reward Deficiency Syndrome.” Neuropsychiatric Disease and Treatment, vol. 4, no. 5, Oct. 2008, pp. 893–918. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/.)) This condition affects at least one of the genes responsible for that process. And that, experts say, “makes it difficult for neurons to respond to dopamine.”

In other words, even if you have healthy dopamine levels, it may not feel that way. So things that “should” be pleasurable might not always feel as good as you want them to.

If nothing feels good enough, it makes sense to go looking for new types of stimulation. This may explain the link between ADHD and risk-taking. ((Shoham, Rachel, et al. “ADHD-Associated Risk Taking Is Linked to Exaggerated Views of the Benefits of Positive Outcomes.” Scientific Reports, vol. 6, no. 1, Oct. 2016, p. 34833. www.nature.com, https://doi.org/10.1038/srep34833.))

Drug use falls neatly into this category.

Dopamine and Addiction

Over time, addiction makes the brain less sensitive to dopamine. ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 14 Dec. 2022.)) At first, your brain starts associating drugs with a sense of reward. The act of taking drugs triggers a release of dopamine, whether or not the drug itself does.

As you get used to this repeated flood of dopamine, you’ll feel less satisfaction from taking drugs. This effectively increases your tolerance to the drug, so you need to take more of it to achieve the same result. At the same time, you start feeling less pleasure from other activities. So even if you no longer enjoy the sensation of being high, you might still feel driven to take drugs.

These behaviors quickly become a vicious cycle. Psychiatrist and dopamine expert Dr. Anna Lembke explains that for people in this state, joy is often out of reach. “Now, our drug of choice doesn’t even get us high,” she says. “It just makes us feel normal.” ((Hu, Elise, and Audrey Nguyen. “Too Much Pleasure Can Lead to Addiction. How to Break the Cycle and Find Balance.” NPR, 4 Apr. 2022. NPR, https://www.npr.org/2022/03/31/1090009509/addiction-how-to-break-the-cycle-and-find-balance.))

But if you have ADHD, addiction recovery might not be enough to break the cycle. You might stop taking drugs, but still feel unsatisfied with your life. In order to heal from these co-occurring disorders, it’s important to find treatment for both of them.

Treatment for ADHD and Addiction

ADHD is often diagnosed in children ((Braaten, Ellen. “5 Things Parents and Teachers Need to Know about ADHD.” Harvard Health, 27 Oct. 2017, https://www.health.harvard.edu/blog/5-things-parents-and-teachers-need-to-know-about-adhd-2017102712643. and teens, and some people grow out of their symptoms. But that’s not true for everyone. And recent data shows that you can develop ADHD as an adult, ((“‘Late-Onset’ ADHD May Emerge in Young Adults.” Psychiatric Times, https://www.psychiatrictimes.com/view/late-onset-adhd-may-emerge-young-adults. Accessed 14 Dec. 2022.)) even if you showed no signs of it in childhood.

Because of these complexities, you might need different types of treatment in different stages of recovery. And after you complete rehab, you may benefit from ongoing care for addiction, ADHD, or both. Certain therapies are especially helpful for people with these diagnoses.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular treatment for many mental health conditions. And a wealth of data supports CBT as a therapy for ADHD and addiction. ((Zulauf, Courtney A., et al. “The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders.” Current Psychiatry Reports, vol. 16, no. 3, Mar. 2014, p. 436. PubMed Central, https://doi.org/10.1007/s11920-013-0436-6.)) This framework focuses more on practical skills than it does on emotional processing. Your therapist will teach you coping strategies for dealing with difficult thoughts, urges, social situations, and more. In between sessions, you’ll try them out in your daily life.

Integrated Cognitive Behavioral Therapy

As the name implies, integrated cognitive behavioral therapy (ICBT) integrates components of CBT ((Capone, Christy, et al. “Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study.” Journal of Traumatic Stress Disorders & Treatment, vol. 3, no. 4, 2014, p. 1000134. PubMed Central, https://doi.org/10.4172/2324-8947.1000134.)) and other treatment methods. Patients learn about their condition, practice mindfulness, and learn flexible thinking skills. You’ll use a workbook, and your therapist will give you homework assignments to complete between sessions. This format empowers clients to develop practical skills and put them to use in real-life situations.

ICBT is a highly effective treatment for co-occurring ADHD and addiction. ((van Emmerik-van Oortmerssen, Katelijne, et al. “Integrated Cognitive Behavioral Therapy for ADHD in Adult Substance Use Disorder Patients: Results of a Randomized Clinical Trial.” Drug and Alcohol Dependence, vol. 197, Apr. 2019, pp. 28–36. PubMed, https://doi.org/10.1016/j.drugalcdep.2018.12.023.)) One study even found it to be more effective than other forms of CBT. ICBT can also treat post-traumatic stress disorder (PTSD). ((McGovern, Mark. Integrated Cognitive Behavioral Therapy for Co-Occurring PTSD and Substance Use Disorders. Clinical trial registration, NCT01457404, clinicaltrials.gov, 23 Oct. 2015. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01457404.)) However, like most types of talk therapy, ICBT focuses on mental, emotional, and behavioral issues. Since ADHD is also a neurochemical issue, many people need medical treatment as well.

Medication for ADHD

Prescribing medication to treat co-occurring ADHD and addiction ((Mariani, John J., and Frances R. Levin. “Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders.” The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, vol. 16, no. Suppl 1, 2007, pp. 45–56. PubMed Central, https://doi.org/10.1080/10550490601082783.)) is a controversial issue. If a patient has ADHD without addiction, prescription stimulants are the standard treatment. But stimulants are highly addictive. Because of this, experts disagree about the best course of action.

This controversy even affects people with ADHD who have no history of drug abuse. Some sources caution against treating ADHD with stimulants ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) because of the risk of future addiction. Others say prescribed stimulants protect against addiction, ((APA PsycNet. https://psycnet.apa.org/record/2013-43688-006. Accessed 14 Dec. 2022.)) because they empower patients to manage symptoms in a healthy way.

During addiction recovery, taking medication of any kind can be complicated. Tell your doctor about your history before you start a new prescription. Together, you can make a plan to keep yourself safe. For example, they might only prescribe you a few pills at a time, and ask you to come back into their office before you can get more.

Whatever treatments you pursue, it’s essential for you to get an official diagnosis first. That can be surprisingly difficult, especially for people of certain demographics.

Getting an Accurate Diagnosis

Because of the overlapping symptoms of ADHD and addiction, ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) doctors can’t always distinguish between them. This means that if you already have an ADHD diagnosis, you might need to start addiction treatment before you can get one. Most rehabs start their program with thorough assessments, so it’s relatively easy to get assessed for ADHD while you’re in residential treatment. Some doctors even recommend screening everyone in addiction treatment for ADHD. ((Matthys, Frieda, et al. “[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].” Nederlands tijdschrift voor geneeskunde, vol. 157, no. 24, Jan. 2013, p. A6025.))

In some populations, though, ADHD is harder to diagnose. There are several possible reasons for this. Many clinicians have a preconceived image of what ADHD patients look like. This makes it easy to miss the symptoms when they present in a different way. It can also be hard to differentiate between ADHD and other mental health issues.

ADHD in Teens

For children and teens with ADHD, ((“Severity of ADHD in Children Increases Risk of Drug Use in Adolescence, Says Longitudinal Study.” Https://Www.Apa.Org, https://www.apa.org/news/press/releases/2003/08/adhd-drugs. Accessed 14 Dec. 2022.)) early diagnosis is key. That’s because children with more severe ADHD symptoms are at a greater risk of developing addiction later on. However, ADHD symptoms may not appear before puberty. ((Ostojic, Dragana, and Carlin J. Miller. “Association Between Pubertal Onset and Symptoms of ADHD in Female University Students.” Journal of Attention Disorders, vol. 20, no. 9, Sept. 2016, pp. 782–91. DOI.org (Crossref), https://doi.org/10.1177/1087054714535249.)) And because even healthy teenagers go through behavioral changes, that timing can make it difficult for parents to notice a problem. While this can be an issue for teens of any gender, it’s most common among young women.

Women With ADHD

Data suggests that up to 75% of women with ADHD may be undiagnosed. ((Walters, Anne. “Girls with ADHD: Underdiagnosed and Untreated.” The Brown University Child and Adolescent Behavior Letter, vol. 34, no. 11, Nov. 2018, pp. 8–8. DOI.org (Crossref), https://doi.org/10.1002/cbl.30337.)) That might be because women with ADHD often show different symptoms ((Quinn, Patricia O., and Manisha Madhoo. “A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis.” The Primary Care Companion for CNS Disorders, vol. 16, no. 3, 2014. www.ncbi.nlm.nih.gov, https://doi.org/10.4088/PCC.13r01596.)) than clinicians expect.

For example, one study found that women were more likely to be inattentive than hyperactive. Inattention primarily affects the person feeling it. Your inability to focus on your book won’t distract a stranger at a bus stop. But hyperactivity, which is common in men with ADHD, can be disruptive in a group setting. Both clinicians and patients’ loved ones commonly miss “internalizing” symptoms like inattentiveness. Instead, women with ADHD are often misdiagnosed with bipolar disorder, anxiety, or depression.

Differentiating Between ADHD and Anxiety

ADHD and anxiety ((Pliszka, Steven R. “ADHD and Anxiety: Clinical Implications.” Journal of Attention Disorders, vol. 23, no. 3, Feb. 2019, pp. 203–05. DOI.org (Crossref), https://doi.org/10.1177/1087054718817365.)) often go hand in hand. While ADHD is not an anxiety disorder, ((ADHD and Anxiety: What’s the Connection? 15 May 2017, https://www.medicalnewstoday.com/articles/315303.
)) they can present with similar symptoms. For instance, either condition might get in the way of finishing your homework. In people with ADHD, that’s probably because you just can’t focus. On the other hand, people with anxiety might be able to focus, but afraid of getting it wrong.

ADHD can also cause anxiety. That’s because its symptoms make it harder to achieve your goals. Some people get anxious about the impact ADHD has on their lives. Without proper treatment, it’s all too easy to get stuck in this loop.

If you have both of these conditions, it’s important to get the right diagnosis before taking medication. Otherwise, you’ll risk making your symptoms worse. ADHD patients commonly take stimulants, which can increase anxiety. ((Stimulants – Alcohol and Drug Foundation. https://adf.org.au/drug-facts/stimulants/. Accessed 14 Dec. 2022.)) Stimulants may still be a good fit for some people with anxiety disorders—it all depends on your specific health history. You can work closely with your doctor to design a care plan that meets your needs.

ADHD May Be a Risk Factor for Depression

There’s less of an overlap between the symptoms of ADHD and depression, but they have a strong correlation. People with ADHD often develop depression ((Riglin, Lucy, et al. “ADHD and Depression: Investigating a Causal Explanation.” Psychological Medicine, vol. 51, no. 11, Aug. 2021, pp. 1890–97. Cambridge University Press, https://doi.org/10.1017/S0033291720000665.)) later in life, even if they grow out of childhood ADHD symptoms.

There may be a genetic link between these conditions. And people with ADHD and depression often have other mental health issues, like addiction or trauma. Recovering from these co-occurring disorders is complex. You may require specialized care, and ongoing treatment even after rehab.

Post-traumatic Stress Disorder

Everyone experiences trauma differently. Something that feels like just a bad day to you might be deeply traumatizing for someone else. And your personal history can make you more or less likely to develop post-traumatic stress disorder (PTSD).

ADHD increases your risk of developing PTSD ((Biederman, Joseph, et al. “Is ADHD a Risk for Posttraumatic Stress Disorder (PTSD)? Results from a Large Longitudinal Study of Referred Children with and without ADHD.” The World Journal of Biological Psychiatry, vol. 15, no. 1, Jan. 2014, pp. 49–55. DOI.org (Crossref), https://doi.org/10.3109/15622975.2012.756585.
)) in response to trauma. That’s especially true for people with both ADHD and alcohol addiction. ((Luderer, Mathias, et al. “ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 245–53. www.karger.com, https://doi.org/10.1159/000508918.)) And data shows that people with ADHD experience a higher number of traumatic events, whether or not they develop PTSD.

If you have trauma symptoms, you might benefit from trauma-informed care (TIC). TIC is a general approach to treatment, not a specific type of therapy. This means you can get trauma-informed care for ADHD, addiction, PTSD, and any other concerns you’re seeking help for.

Many Roads to Recovery

Everyone’s recovery is unique, and that’s doubly true for people with co-occurring disorders. Your provider will help you design a care plan that accounts for your various goals.

The act of healing can empower you to understand the depth of your emotional experience. That’s how it happened for Peach Perkins.

Peach is in recovery from ADHD, alcohol and drug addiction, ((ADHD and Substance Abuse: ADHD Aha! Podcast. https://www.understood.org/en/podcasts/adhd-aha/adhd-and-substance-abuse-peachs-story. Accessed 14 Dec. 2022.)) as they explained on the podcast ADHD Aha! But it took them almost a year of sobriety to understand how those conditions worked together. At first, they thought addiction was “the thing preventing me from doing a good job at work. Now I can really go all in. And I was still at work, just my eyes were crossed and I still couldn’t do what I needed to do. That wasn’t what was in my way.” After that realization, they were able to get an official ADHD diagnosis. With the right diagnosis, they finally got the treatment they needed—and you can too.

Find Balance in Treatment for ADHD and Addiction

ADHD is often, but not always, a life-long condition. Recovery usually doesn’t mean getting rid of your symptoms entirely. Instead, you’ll learn to manage them in a healthier way. And those coping skills can make it easier to heal from co-occurring diagnoses like addiction.

Learn more about rehab programs for ADHD, including their locations, pricing, insurance coverage, and more.

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Holistic Recovery From Eating Disorders

Eating disorders can be isolating. And that’s hard enough on a social level, if you’re skipping group activities that include shared meals. But it’s more than social. These conditions can also make you feel disconnected from yourself.

If that’s your experience, holistic treatment for eating disorders might be a good fit. This approach invites you to reconnect your mind and body. Some therapies take it a step further, teaching you healthy ways of relating to the world. Over time, you can learn to ground yourself in your own needs and values. And from that foundation, you can make empowered decisions about your recovery process.

What Is Holistic Treatment?

Holistic treatment doesn’t just treat your symptoms. Instead, it focuses on you as a whole person, with complex recovery goals. This approach is rooted in Eastern philosophies. And while it’s not a replacement for evidence-based therapies, holistic care has many unique advantages.

By definition, this type of treatment is not one-size-fits-all. However, many holistic rehab programs share certain ideals. For example, they may encourage mindfulness as a treatment for eating disorders. ((Wanden-Berghe, Rocío Guardiola, et al. “The Application of Mindfulness to Eating Disorders Treatment: A Systematic Review.” Eating Disorders, vol. 19, no. 1, Dec. 2010, pp. 34–48. DOI.org (Crossref), https://doi.org/10.1080/10640266.2011.533604.))

Why Mindfulness Matters

Here’s the secret about mindfulness: anyone can do it. You can practice mindful meditation, or you can be mindful while you’re washing the dishes. And with enough practice, it can become a way of life.

When you act mindfully, ((“What Are the Benefits of Mindfulness?” Https://Www.Apa.Org, https://www.apa.org/monitor/2012/07-08/ce-corner. Accessed 12 Dec. 2022.)) you pay attention to your own experience, and to the world around you. You might notice tension in your shoulders, or the sound of the washing machine, or your sense of anxiety about catching the train. By cultivating this greater awareness, you can learn to regulate your feelings. And emotion regulation is a big part of healing from an eating disorder.

Mindful Recovery From Eating Disorders

Eating disorders can make it feel like your body and mind are out of sync. You might find yourself ruminating about your eating habits, ((Cowdrey, Felicity A., and Rebecca J. Park. “The Role of Experiential Avoidance, Rumination and Mindfulness in Eating Disorders.” Eating Behaviors, vol. 13, no. 2, Apr. 2012, pp. 100–05. ScienceDirect, https://doi.org/10.1016/j.eatbeh.2012.01.001.)) so focused on what you think of your body that you forget how you feel. Those thoughts can manifest as unhealthy eating behaviors, regardless of your physical needs. In fact, eating disorders can make it hard to recognize natural cues like hunger and fullness. ((Wolever, Ruth Q., and Jennifer L. Best. “Mindfulness-Based Approaches to Eating Disorders.” Clinical Handbook of Mindfulness, edited by Fabrizio Didonna, Springer, 2009, pp. 259–87. Springer Link, https://doi.org/10.1007/978-0-387-09593-6_15.))

Mindfulness increases body awareness, ((Baer, Ruth A. Mindfulness-Based Treatment Approaches: Clinician’s Guide to Evidence Base and Applications. Elsevier, 2015.)) addressing this disconnect. When you act mindfully you bring your body and mind back together, meeting yourself in the present moment. Many people find this practice grounding, comforting, and even empowering. There are several specific treatments that promote mindful, holistic healing.

Types of Holistic Recovery

Holistic rehab honors the fact that you’re a unique person, with a unique definition of wellness. While mindfulness is a big part of many holistic treatments, it’s not always central to recovery. Depending on your exact needs, your provider may recommend a combination of several types of therapy.

Yoga

Doing yoga in rehab helps patients build both physical and emotional strength. Certain poses may be hard at first, and it takes willpower to practice them. Over time, as you get better at it, you might also develop more confidence. And because yoga asks you to be present in the moment, you’ll also practice self-acceptance. This empowers you to observe and care for your body just as it is, instead of passing judgment.

Data shows that yoga can improve your body image ((Neumark-Sztainer, Dianne, et al. “Yoga and Body Image: How Do Young Adults Practicing Yoga Describe Its Impact on Their Body Image?” Body Image, vol. 27, Dec. 2018, pp. 156–68. ScienceDirect, https://doi.org/10.1016/j.bodyim.2018.09.001.)) and overall sense of well-being. Unlike some forms of exercise, the goal isn’t to look or even feel a certain way. Instead, it invites you to exist safely in your own body. For people with eating disorders, that can be transformative.

If you’re new to yoga, it’s important to learn from an expert. But once you understand the basics, you can practice almost anywhere, at any point during recovery. While you’re in treatment, some providers combine yoga and eating disorder education. ((Neumark-Sztainer, Dianne. “Yoga and Eating Disorders: Is There a Place for Yoga in the Prevention and Treatment of Eating Disorders and Disordered Eating Behaviours?” Advances in Eating Disorders, vol. 2, no. 2, May 2014, pp. 136–45. DOI.org (Crossref), https://doi.org/10.1080/21662630.2013.862369.)) And when you leave rehab, you can easily incorporate it into your plan for aftercare. This healthy coping skill can help you bridge the gap between different stages of healing.

Nutrition

Good nutrition is a vital part of eating disorder recovery. When you first enter treatment, you might need to replenish certain vitamins and minerals. In that case, your care team may personalize your meal plan, or even provide medical treatment. But there’s more to nutrition than receiving this type of care.

In some rehabs, you’ll also work directly with a nutritionist or dietitian. These experts can teach you to plan healthy menus based on your nutritional requirements. They might even help you shop for groceries or learn to cook. It’s important to practice these skills during treatment, so you’re set up for success when you return home. Over time, you’ll develop these healthier habits—and even more importantly, you’ll develop intuition about your own needs. By rebuilding trust within yourself, you can improve your relationship with food.

Acupuncture

Acupuncture is a form of traditional Chinese medicine ((“Acupuncture: What You Need To Know.” NCCIH, https://www.nccih.nih.gov/health/acupuncture-what-you-need-to-know. Accessed 12 Dec. 2022.)) in which thin needles are inserted into pressure points around the body. The goal of this is to unblock the flow of qi, or life force energy, promoting physical and mental health.

Because it treats both physical and emotional issues, acupuncture supports eating disorder recovery. ((Fogarty, Sarah, et al. “Acupuncture as an Adjunct Therapy in the Treatment of Eating Disorders: A Randomised Cross-over Pilot Study.” Complementary Therapies in Medicine, vol. 18, no. 6, Dec. 2010, pp. 233–40. ScienceDirect, https://doi.org/10.1016/j.ctim.2010.09.006.)) This technique doesn’t just treat your symptoms. It also helps patients heal from the underlying causes of their diagnosis. For example, acupuncture can simultaneously reduce anxiety and improve digestion. By treating these issues together, it teaches patients how connected their minds and bodies really are.

Mindfulness-Based Eating Awareness Training

Mindfulness-based eating awareness training (MB-EAT) ((Kristeller, Jean L., and Ruth Q. Wolever. “Mindfulness-Based Eating Awareness Training for Treating Binge Eating Disorder: The Conceptual Foundation.” Eating Disorders, vol. 19, no. 1, Dec. 2010, pp. 49–61. DOI.org (Crossref), https://doi.org/10.1080/10640266.2011.533605.)) uses guided meditations to support recovery. Treatment targets the negative thoughts associated with eating disorders. Patients also practice mindfulness and emotion regulation skills. For example, MB-EAT teaches you to notice how hunger and fullness actually feel in your body.

MB-EAT can be especially helpful if you have a binge eating disorder. By riding the waves of your urges, you can stay in touch with your body, but avoid unhealthy behavior. These skills help you accept your feelings just as they are, without always acting on them.

Find Wholeness in Rehab for Eating Disorders

You are more than the sum of your parts. Those parts include the way you look, the way your body feels, your mental health, and your healing journey. But that’s an incomplete list. Holistic treatment honors the complexity of each person’s identity. And it invites you to learn who you already are, and decide who you want to become.

Connect with a rehab that treats eating disorders to find out which holistic therapies they offer.

Reviewed by Lisa Misquith

Posted on

Unplug From Gaming Addiction and Reconnect With Real Life

In moderation, video games can be a great way to unwind. But gaming can take over your life. If it goes from a casual hobby to an all-consuming part of your routine, you might need support to get back on track. And there are many ways to approach recovery. You can even go to rehab for gaming addiction.

Treatment Options for Gaming Addiction

Addiction doesn’t always include taking drugs—it can also be behavioral. In fact, some of the best therapies for gaming addiction can also treat other types of addiction. ((Torres-Rodríguez, Alexandra, et al. “The Treatment of Internet Gaming Disorder: A Brief Overview of the PIPATIC Program.” International Journal of Mental Health and Addiction, vol. 16, no. 4, 2018, pp. 1000–15. PubMed Central, https://doi.org/10.1007/s11469-017-9825-0.))

Adventure Therapy Gives You Other Outlets

Adventure therapy can be exciting. During treatment, you’ll explore the great outdoors and learn new skills. This popular therapy for gaming addiction ((Pilar, Elmar. Computer Game Addiction -Symptoms, Treatment, & FAQs What Is Computer Game Addiction. www.academia.edu, https://www.academia.edu/31271724/Computer_Game_Addiction_Symptoms_Treatment_and_FAQs_What_is_computer_game_addiction. Accessed 12 Dec. 2022.)) also invites you to connect with other people. By solving problems together, you can learn to support each other in person—not just through a screen. Wilderness therapy, in particular, offers important benefits during recovery from gaming addiction:

  • Treatment includes an extended period of time (usually 30 days) away from the game.
  • Outdoor activities reinforce different strengths than video gaming.
  • Spending time outside can become a healthier hobby.

This approach invites you to heal and have fun at the same time. As you rock climb, kayak, or hike, you’ll also develop greater self-awareness and confidence.

Change How You Think About Gaming With Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a common method for treating gaming addiction. ((Király, Orsolya, et al. “Policy Responses to Problematic Video Game Use: A Systematic Review of Current Measures and Future Possibilities.” Journal of Behavioral Addictions, vol. 7, no. 3, pp. 503–17. PubMed Central, https://doi.org/10.1556/2006.6.2017.050. Accessed 12 Dec. 2022.)) It can also treat people with internet addiction. ((Kuss, Daria J., and Olatz Lopez-Fernandez. “Internet Addiction and Problematic Internet Use: A Systematic Review of Clinical Research.” World Journal of Psychiatry, vol. 6, no. 1, Mar. 2016, pp. 143–76. PubMed Central, https://doi.org/10.5498/wjp.v6.i1.143.)) During each session, you and your therapist will talk through your most frequent thought patterns. Then, they’ll teach you practical ways to cope with those thoughts. For example, you might practice these skills:

  • identifying negative impacts gaming has on your life
  • exercising self-restraint
  • communicating with other people and building relationships

The skills you learn in therapy will help you manage your symptoms. But that’s not the only reason CBT is effective for treating gaming addiction. ((Kuss, Daria J., and Olatz Lopez-Fernandez. “Internet Addiction and Problematic Internet Use: A Systematic Review of Clinical Research.” World Journal of Psychiatry, vol. 6, no. 1, Mar. 2016, p. 143. www.ncbi.nlm.nih.gov, https://doi.org/10.5498/wjp.v6.i1.143.)) This therapy also treats the underlying causes of gaming addiction, like impulse control.

Reconnect With Loved Ones in Family Therapy

Gaming addiction can damage your relationships. But the reverse is also true: an unhealthy family environment is a risk factor for gaming addiction. ((Torres-Rodríguez, Alexandra, et al. “The Treatment of Internet Gaming Disorder: A Brief Overview of the PIPATIC Program.” International Journal of Mental Health and Addiction, vol. 16, no. 4, 2018, pp. 1000–15. PubMed Central, https://doi.org/10.1007/s11469-017-9825-0.)) If that’s your experience, family therapy might be an important part of recovery.

Data shows that family therapy can improve gaming addiction symptoms. ((Zajac, Kristyn, et al. “Treatments for Internet Gaming Disorder and Internet Addiction: A Systematic Review.” Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, vol. 31, no. 8, Dec. 2017, pp. 979–94. PubMed Central, https://doi.org/10.1037/adb0000315.)) Specifically, this treatment lowers the time patients spend gaming or just being online. It also helps family members understand why their loved one has a gaming addiction. That makes it easier for them to support the person through recovery.

Access Motivational Interviewing Online or in Person

Motivational interviewing (MI) helps patients define their own reasons for wanting to recover. When the desire to heal comes from within, committing to treatment gets easier. MI is a common treatment for gaming addiction. ((Zajac, Kristyn, et al. “Treatments for Internet Gaming Disorder and Internet Addiction: A Systematic Review.” Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, vol. 31, no. 8, Dec. 2017, pp. 979–94. PubMed Central, https://doi.org/10.1037/adb0000315.))

You can access MI in a variety of ways, such as in therapy, from another clinician, or even remotely. In fact, some forms of online MI are specifically designed to treat gaming addiction. ((Dieris-Hirche, Jan, et al. “Effects of an Online-Based Motivational Intervention to Reduce Problematic Internet Use and Promote Treatment Motivation in Internet Gaming Disorder and Internet Use Disorder (OMPRIS): Study Protocol for a Randomised Controlled Trial.” BMJ Open, vol. 11, no. 8, Aug. 2021, p. e045840. PubMed Central, https://doi.org/10.1136/bmjopen-2020-045840.)) Data shows this type of treatment can be hugely effective.

Find Offline Community in Support Groups

Gaming might give you a sense of community. But that community won’t necessarily protect you from addiction. On the contrary, it might even make your symptoms worse. Addiction support groups offer a healthy alternative.

If the 12 Steps resonate with you, Gaming Addicts Anonymous might be a good place to start. However, faith-based recovery isn’t a good fit for everyone. In that case, you can consider non-12-Step groups that welcome people with any type of addiction, like SMART Recovery. But even if you don’t join a support group, it’s important to start building relationships with people who understand what you’re going through.

What Is Gaming Addiction?

When compared to other addictions, gaming is relatively new. Perhaps because of this, there are some common misconceptions about gaming addiction. ((Fu, Daniel. “A Look at Gaming Culture and Gaming Related Problems: From a Gamer’s Perspective.” Center Report, Dept. of Psychology, UCLA. http://smhp.psych.ucla.edu/pdfdocs/gaming.pdf)) But if you’re showing the symptoms of addiction, it’s important to take them seriously.

Gaming addiction is a preoccupation with gaming that interferes with all other parts of your life. ((Kim, Dongil, et al. “Adolescent Internet Gaming Addiction and Personality Characteristics by Game Genre.” PLoS ONE, vol. 17, no. 2, Feb. 2022, p. e0263645. PubMed Central, https://doi.org/10.1371/journal.pone.0263645.)) People with this condition may lie about how much they play, lose interest in other activities, and develop sleep issues. You can even experience withdrawal symptoms, like cravings, when you try to take a break.

Who Is at Risk for Gaming Addiction?

Addiction doesn’t happen in a vacuum. That’s true for drug use, gambling, and any other unhealthy behavior. And there are certain factors that increase your risk of gaming addiction: ((Torres-Rodríguez, Alexandra, et al. “The Treatment of Internet Gaming Disorder: A Brief Overview of the PIPATIC Program.” International Journal of Mental Health and Addiction, vol. 16, no. 4, 2018, pp. 1000–15. PubMed Central, https://doi.org/10.1007/s11469-017-9825-0.))

  • genetic predisposition, including a family history of addiction
  • psychological issues, like low self-esteem
  • environmental factors, like family conflict
  • stress, including grief or major life changes

Additionally, some demographics are more likely to develop video game addiction. ((TAŞ, Besra. “School Attachment and Video Game Addiction of Adolescents with Divorced vs. Married Parents.” TOJET: The Turkish Online Journal of Educational Technology – April 2019, volume 18 issue 2. https://files.eric.ed.gov/fulltext/EJ1211160.pdf)) Specifically, young people and boys may be at a greater risk.

Gaming Addiction and Other Mental Health Issues

Many people with video game addiction have co-occurring disorders, ((Kim, Dongil, et al. “Adolescent Internet Gaming Addiction and Personality Characteristics by Game Genre.” PLoS ONE, vol. 17, no. 2, Feb. 2022, p. e0263645. PubMed Central, https://doi.org/10.1371/journal.pone.0263645.)) like anxiety or depression. Some of the most common co-occurring mental health issues ((Torres-Rodríguez, Alexandra, et al. “The Treatment of Internet Gaming Disorder: A Brief Overview of the PIPATIC Program.” International Journal of Mental Health and Addiction, vol. 16, no. 4, 2018, pp. 1000–15. PubMed Central, https://doi.org/10.1007/s11469-017-9825-0.)) include the following:

  • anxiety, especially social anxiety
  • ADHD
  • depression
  • certain personality disorders
  • autism

If you have more than one diagnosis, it’s important to give each one the attention it deserves. Often that means getting treatment for co-occurring disorders. This approach may give you more insight into your complex emotional experience.

What Leads to Gaming Addiction?

No matter who you are, or what risk factors you face, 2 types of games make addiction more likely: ((Kim, Dongil, et al. “Adolescent Internet Gaming Addiction and Personality Characteristics by Game Genre.” PLoS ONE, vol. 17, no. 2, Feb. 2022, p. e0263645. PubMed Central, https://doi.org/10.1371/journal.pone.0263645.))

  1. massively multiplayer online role-playing games (MMORPGs), like World of Warcraft, and
  2. first-person shooters, like Overwatch.

Different games also correlate with different addiction symptoms. For example, people who play first-person shooters tend to be more impulsive. But people with addiction to MMORPGs are often more extroverted, even if gaming gets in the way of in-person relationships. It’s also worth noting that not everyone who plays MMORPGs or first-person shooters is at risk of gaming addiction. Why you’re playing matters just as much as what you’re playing.

The Need for Escape

Some people use games to avoid real-life issues. ((Wang, Shuai, et al. “Escapism-Based Motivation Affected the Psychological Performances of High-Risk Internet Gaming Disorder Individuals.” Frontiers in Psychiatry, vol. 13, Mar. 2022, p. 855631. PubMed Central, https://doi.org/10.3389/fpsyt.2022.855631.)) This is most common with MMORPGs, ((Kim, Dongil, et al. “Adolescent Internet Gaming Addiction and Personality Characteristics by Game Genre.” PLoS ONE, vol. 17, no. 2, Feb. 2022, p. e0263645. PubMed Central, https://doi.org/10.1371/journal.pone.0263645.)) in which players take on an in-game persona. And most of the time, your character faces less complicated issues than you do. Fighting a dragon is easy once you’re good at the game. And it has a straightforward outcome: win or lose. Either way, you’re still the main character. Most of the time, real life is much messier than that.

Many escapist gamers have low emotional and impulse control. ((Mehmet Emin Turani. “Empathy and Video Game Addiction in Adolescents: Serial Mediation by Psychological Resilience and Life Satisfaction.” International Journal of Progressive Education, Volume 17 Number 4, 2021. https://files.eric.ed.gov/fulltext/EJ1308639.pdf)) As a result, it can be hard to manage the stress of daily life. Instead, people turn to fictional worlds that reward impulsive behavior. But this just compounds the issue. If this is your experience, you might practice emotion regulation skills during recovery.

Relying on Video Games for Community

Gaming can fulfill players’ need for connection, ((Kim, Dongil, et al. “Adolescent Internet Gaming Addiction and Personality Characteristics by Game Genre.” PLoS ONE, vol. 17, no. 2, Feb. 2022, p. e0263645. PubMed Central, https://doi.org/10.1371/journal.pone.0263645.)) especially if you don’t have many strong relationships in real life. It might even feel easier for you to talk to people when you’re behind a screen. Studies show that people with gaming addiction feel closer to other people during online interactions than they do in person.

Over time, this can become a vicious cycle. First, you reach out online by gaming. But as your addiction develops, you may lose interest in your real-world relationships. And as you let go of those friendships, it can feel like gaming is your primary source of connection. In treatments like wilderness therapy, patients relearn how to build sustainable relationships.

Instant Gratification

Video games are meant to be engaging. ((Söylemez, A. (2021). The prediction role of delay of gratification on
game addiction in children. Malaysian Online Journal of Educational
Technology, 9(2), 67-75.
http://dx.doi.org/10.52380/mojet.2021.9.2.255)) Game developers want you to continue playing. That’s one reason they offer so many rewards. Leveling up gives you instant access to new skills, with no studying required. This pattern appeals to people who feel unsuccessful outside of gameplay. Research shows a relationship between gaming addiction and low self-esteem. ((Kim, Dongil, et al. “Adolescent Internet Gaming Addiction and Personality Characteristics by Game Genre.” PLoS ONE, vol. 17, no. 2, Feb. 2022, p. e0263645. PubMed Central, https://doi.org/10.1371/journal.pone.0263645.))

Doing well in a game can give you a sense of accomplishment. It may also earn you the respect of fellow gamers, which can boost your self-image. However, these achievements don’t prepare you for the hard work of building a meaningful life. There’s no loot drop after you deal with a breakup, or retake a failed exam. But often, those experiences are necessary in order for you to grow as a person.

A Sense of Purpose

Unlike most areas of life, video games have clear storylines. Even when you’re exploring an open world, you usually have a specific quest in mind. If you feel lost and driftless when you’re offline, gaming addiction can satisfy your need for a personal mission. ((Carmona, Jayson. “Escaping the Escapism: A Grounded Theory of the Addiction and Recovery Process in Online Video Gaming.” The Qualitative Report, Volume 26, Number 7, Article 5. https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=4643&context=tqr))

This can be true for people without clear goals, and also for those with lofty ambitions. Most of the time, the stakes are lower in a boss fight than they would be if you applied to law school. And you might feel more confident about winning the game than you do about achieving your dreams. But if you let gaming take up too much of your time, it becomes an obstacle in its own right.

Level up Into the Real World

Gaming might feel like a great adventure. To be good at it, you need dedication and creativity. But as you build on those skills, you may find that you need a more complex challenge. With the right support, you can find what you’re looking for in real life.

Browse our list of rehabs for gaming addictions to learn about their pricing, treatment options, and more.

Reviewed by Lisa Misquith

Posted on

Sadness vs. Depression: How to Tell the Difference

Feeling sad is normal—even healthy. It’s a natural part of the human experience. But persistent sadness can cross a line. When this emotion becomes a mental health condition, you might need professional support. The problem is, it can be hard to distinguish between sadness and depression.

There are some key differences between these 2 experiences. But either way, knowing what’s wrong is the first step toward healing. If you need to, you can seek treatment for depression. And if not, you can still take active steps to move past feeling sad.

Working Through Sadness

We all feel sad from time to time; it’s a normal part of being human. Usually, that feeling has a clear external cause. For instance, sadness is often associated with grief ((Lokko, Hermioni N., and Theodore A. Stern. “Sadness: Diagnosis, Evaluation, and Treatment.” The Primary Care Companion for CNS Disorders, vol. 16, no. 6, Nov. 2014, p. 10.4088/PCC.14f01709. PubMed Central, https://doi.org/10.4088/PCC.14f01709.)) or loss. There’s nothing wrong with this important emotion, and it doesn’t need to be pushed away. But—if it’s really sadness, and not depression—there’s a lot you can do to support yourself as you ride out the experience.

Make a Change

Most of the time, you can point to a specific reason you’re feeling sad. Maybe you failed an exam or lost a job. Upsetting as these issues are, they can inspire you. You might recommit to studying, so you’ll get better grades on future tests. Or, you might look for a new job where your skills can really shine. Taking action is empowering. And as you work to improve your life, your feelings might improve too.

Get Social Support

There’s a link between sadness and loneliness. ((Yanguas, Javier, et al. “The Complexity of Loneliness.” Acta Bio Medica : Atenei Parmensis, vol. 89, no. 2, 2018, pp. 302–14. PubMed Central, https://doi.org/10.23750/abm.v89i2.7404.)) So when you’re feeling sad, spending time with people you trust can make you feel better. Your loved ones are allies for your happiness. Their support can give you a new perspective on your own feelings, or just a welcome distraction. Either way, shifting your focus away from sadness can help you move forward. ((“Probing the Depression-Rumination Cycle.” Https://Www.Apa.Org, https://www.apa.org/monitor/nov05/cycle. Accessed 12 Dec. 2022.))

Defining Clinical Depression

Life doesn’t stop when you’re sad. You can go about your day, taking care of responsibilities at home, work, and school. Depression takes a greater toll. ((Duggal, Harpreet S. “Self-Management of Depression: Beyond the Medical Model.” The Permanente Journal, vol. 23, May 2019, pp. 18–295. PubMed Central, https://doi.org/10.7812/TPP/18-295.)) You might feel like everything is a chore—even hobbies and plans with friends. This condition can even have physical symptoms.

Symptoms of Depression

Depression can change your brain chemistry. ((Syvälahti, E. K. “Biological Aspects of Depression.” Acta Psychiatrica Scandinavica. Supplementum, vol. 377, 1994, pp. 11–15. PubMed, https://doi.org/10.1111/j.1600-0447.1994.tb05795.x.)) And while intense, persistent sadness is a common symptom, it’s not the only one. Depression can also manifest in your body, ((“Depression.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/depression. Accessed 12 Dec. 2022.)) with effects like insomnia, weight changes, or physical pain. This is one reason that treatment usually includes medication. ((Depression: How Effective Are Antidepressants? Institute for Quality and Efficiency in Health Care (IQWiG), 2020. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK361016/.))

Unlike sadness, depression rarely goes away with simple activities. It also lasts longer than a run-of-the-mill emotion. If you’ve had the symptoms of depression for longer than 2 weeks, ((“Depression.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/depression. Accessed 12 Dec. 2022.)) it might be time to get professional support.

Root Causes of Depression

It’s usually easy to figure out why you’re sad. Depression is a more complex issue. It often occurs with no apparent cause. According to experts, there may be a genetic component to depression. ((“What Causes Depression?” Harvard Health, 9 June 2009, https://www.health.harvard.edu/mind-and-mood/what-causes-depression.
)) But it can also be intensified by external events.

For example, trauma can cause depression. ((VA.Gov | Veterans Affairs. https://www.ptsd.va.gov/understand/related/depression_trauma.asp. Accessed 12 Dec. 2022.)) But trauma isn’t something you just “get over.” If you’re recovering from depression in response to traumatic events, you might benefit from trauma-informed care for both conditions. When you’re ready to seek treatment, it’s best to get professional advice about where to start.

When Should You Get Help?

If you think you might have depression, talk to your doctor or therapist about your symptoms. Depending on your experience, they might recommend a combination of therapy, medication, inpatient rehab, or other types of treatment. To prepare for this conversation, you can answer a few questions, and share your responses with your care team.

  • How long have you had symptoms? By definition, depression lasts for at least 2 weeks. ((Lokko, Hermioni N., and Theodore A. Stern. “Sadness: Diagnosis, Evaluation, and Treatment.” The Primary Care Companion for CNS Disorders, vol. 16, no. 6, Nov. 2014, p. 10.4088/PCC.14f01709. PubMed Central, https://doi.org/10.4088/PCC.14f01709.)) Sadness usually resolves more quickly.
  • Is it hard for you to keep up with your responsibilities? When your emotions get in the way of daily activities, it’s often a sign of mental health issues.
  • Can you point to a cause? Sadness usually happens for a reason. If you feel sad even when things go well, you might need treatment for depression.
  • Are you considering self-harm? This is a very serious symptom, and requires immediate care.

If you or someone you love is contemplating self-harm, call the 988 Suicide & Crisis Lifeline at 1-800-273-8255 to get immediate support.

No matter how you answer these questions, you can always talk to a therapist about what you’re going through. A professional can offer specific advice, tailored to meet your unique needs.

Finding Your Path Toward Wellness

You and your care team can work together to find the best way forward. And it’s okay to ask for help even before you have serious symptoms. If it turns out that you’re sad, but not depressed, you can still get meaningful support. Or, if you do have depression, your doctor can connect you to the resources you need for recovery.

Browse our list of rehab programs for depression to read reviews, see photos, and learn about pricing options.

Reviewed by Rajnandini Rathod

Posted on

Beyond the Stigma: Recovery From Personality Disorders

Yes, you can find treatment for a personality disorder. These are serious conditions, but they’re not monsters under the bed. Your personality is not broken.

Data shows that there are many effective ways to treat these mental health issues. In a rehab program for personality disorders, you’ll have access to a variety of therapies. Prepare for recovery by learning about your options.

Overcoming the Stigma Around Personality Disorders

As a group, personality disorders are generally misunderstood. ((Sheehan, Lindsay, et al. “The Stigma of Personality Disorders.” Current Psychiatry Reports, vol. 18, no. 1, Jan. 2016, p. 11. PubMed, https://doi.org/10.1007/s11920-015-0654-1.)) And unfortunately, it’s not just the public who carry ignorant views of these diagnoses. Some healthcare providers also have harmful ideas about personality disorders. As a result, stigma is often a barrier to treatment. ((Sheehan, Lindsay. “The Stigma of Personality Disorders.” Curr Psychiatry Rep (2016) 18: 11. BPD Community. https://www.bpdcommunity.com.au/static/uploads/files/2016-sheehan-the-stigma-of-pds-wfcdbbajayss.pdf))

For Amanda Wang, living with borderline personality disorder (BPD) was overwhelming: ((BPD Profile: Struggles, Breakdown & Breakthrough. www.youtube.com, https://www.youtube.com/watch?v=B3t8s2JvVHg. Accessed 11 Dec. 2022.))

“I felt like something was wrong with me. It would start out with something small and it would escalate to thinking that I was probably the worst person in the world and that I wasn’t good enough.”

And without unbiased professional advice, it can be hard to plan your recovery.

So it’s understandable if you’re hesitant to seek help. But facing your condition head-on can empower you to heal. In fact, long-term studies show that remission is common for people with personality disorders, ((Pickersgill, Martyn. “How Personality Became Treatable: The Mutual Constitution of Clinical and Mental Health Law.” Social Studies of Science, vol. 43, no. 1, Feb. 2013, pp. 30–53. PubMed Central, https://doi.org/10.1177/0306312712457722.)) even in the most severe cases. Specialized therapies reduce your symptoms, improve your quality of life, and make it easier to navigate the world.

Not all therapists are qualified to support your healing journey. And it might take a while to find the right provider. Set yourself up for success by researching ahead of time, so you know what to look for in a therapist.

Effective Treatments for Personality Disorders

People with personality disorders rarely start treatment ((Lawton, Erin M., and Thomas F. Oltmanns. “Personality Pathology and Mental Health Treatment Seeking in a Community Sample of Older Adults.” Personality and Mental Health, vol. 7, no. 3, Aug. 2013, p. 10.1002/pmh.1198. PubMed Central, https://doi.org/10.1002/pmh.1198.)) because of those issues alone. More often, patients first enter recovery for addiction or another mental health issue. In that case, you might get diagnosed with a personality disorder once you’re already in rehab.

Once you begin healing, consistency is the key to treatment. ((Pickersgill, Martyn. “How Personality Became Treatable: The Mutual Constitution of Clinical and Mental Health Law.” Social Studies of Science, vol. 43, no. 1, Feb. 2013, pp. 30–53. PubMed Central, https://doi.org/10.1177/0306312712457722.)) With talk therapy and medication, many people make slow, steady progress. Then, for some people, personality disorder symptoms simply vanish in middle age. ((Oltmanns, Thomas F., and Steve Balsis. “Personality Disorders in Later Life: Questions about the Measurement, Course, and Impact of Disorders.” Annual Review of Clinical Psychology, vol. 7, Apr. 2011, pp. 321–49. PubMed Central, https://doi.org/10.1146/annurev-clinpsy-090310-120435.))

To find the right type of therapy, you first need a formal evaluation from a therapist. They’ll assess the intensity of your emotions and your relationships, and ask about other symptoms. Then, with a diagnosis in hand, you and your care team can consider a range of treatment options.

Transference-Focused Psychotherapy Helps You Build Relationships

Transference-focused psychotherapy (TFP) helps you improve your relationships. ((Transference-Focused Psychotherapy Program | Columbia University Center for Psychoanalytic Training and Research. https://www.psychoanalysis.columbia.edu/train/psychotherapy-programs/transference-focused-psychotherapy-program. Accessed 11 Dec. 2022.)) Patients do this by practicing interpersonal skills with a therapist. In that dynamic, you can learn to relate to others’ emotions more easily. This empowers you to build stronger, more sustainable relationships. TFP can treat BPD ((Kernberg, Otto F., et al. “Transference Focused Psychotherapy: Overview and Update.” The International Journal of Psychoanalysis, vol. 89, no. 3, 2008, p. 601. www.academia.edu, https://www.academia.edu/330551/Transference_Focused_Psychotherapy_Overview_and_Update.)) and narcissistic personality disorder, among other conditions.

Most people attend about 2-3 sessions per week for 1-3 years, and get additional support outside of therapy. Your relationship with your therapist is central to this process. By observing the way you act toward them, they’ll learn how you approach other dynamics. Then, they can help you develop healthier behavioral patterns.

Schema-Focused Therapy Soothes Your Inner Child

In schema-focused therapy (ST), you learn how to comfort yourself. ((Tan, Yeow May, et al. “Schema Therapy for Borderline Personality Disorder: A Qualitative Study of Patients’ Perceptions.” PLoS ONE, vol. 13, no. 11, Nov. 2018, p. e0206039. PubMed Central, https://doi.org/10.1371/journal.pone.0206039.)) It’s based on the idea that personality disorders result from childhood trauma. Patients recover by soothing their inner child. ST is especially effective for people with BPD ((Dr. K. Thomaes, MD PhD. “Prediction and Outcome Study in PTSD and Personality disorder.” https://clinicaltrials.gov/ProvidedDocs/53/NCT03833453/Prot_SAP_000.pdf)) and anxious personality disorders, like avoidant personality disorder.

For example, many people with personality disorders were abandoned as children. ((Mahari, A. J. The Legacy of Abandonment In Borderline Personality Disorder. Phoenix Rising Publications, 2006.)) That trauma can cause an intense fear of abandonment in adulthood. ST teaches these patients how to manage that fear. You and your therapist might roleplay a conversation with a parent who abandoned you in the past. You’ll use specific coping skills to regulate your feelings, and still express yourself in a healthy way. This empowers patients to meet their own needs.

Dialectical Behavior Therapy Teaches Emotion Regulation

Dialectical behavior therapy (DBT) teaches you how to process intense emotions healthily. Research shows that DBT reduces symptoms of several personality disorders. ((May, Jennifer M., et al. “Dialectical Behavior Therapy as Treatment for Borderline Personality Disorder.” The Mental Health Clinician, vol. 6, no. 2, Mar. 2016, pp. 62–67. PubMed Central, https://doi.org/10.9740/mhc.2016.03.62.)) Specifically, it helps patients improve impulse control, mindfulness, and emotion regulation.

This is a very practical approach to personality disorder treatment. Treatment includes both individual and group sessions. You’ll go through assignments from a textbook, complete homework, and share what you learn. In some ways, DBT is more like a class than it is like group therapy.

DBT teaches you to accept yourself, ((Chapman, Alexander L. “Dialectical Behavior Therapy.” Psychiatry (Edgmont), vol. 3, no. 9, Sept. 2006, pp. 62–68. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/.)) intense emotions and all. You can’t hate yourself into recovery. Instead, patients cultivate the desire to heal because they deserve to be well.

Mentalization-Based Therapy Lets You Understand Others’ Feelings

Mentalization is related to empathy. ((Schnell, Knut. “Functional relations of empathy and mentalizing: An fMRI study on the neural basis of cognitive empathy.” Elsevier. https://www.researchgate.net/profile/Brigitte-Konradt/publication/45799025_Schnell_K_Bluschke_S_Konradt_B_Walter_H_Functional_relations_of_empathy_and_mentalizing_an_fMRI_study_on_the_neural_basis_of_cognitive_empathy_Neuroimage_54_1743-1754/links/5d63dbb3299bf1f70b0dfece/Schnell-K-Bluschke-S-Konradt-B-Walter-H-Functional-relations-of-empathy-and-mentalizing-an-fMRI-study-on-the-neural-basis-of-cognitive-empathy-Neuroimage-54-1743-1754.pdf)) According to the American Psychological Association, mentalizing ((APA Dictionary of Psychology. https://dictionary.apa.org/. Accessed 11 Dec. 2022.)) is “the ability to understand one’s own and others’ mental states.” This lets you understand why people do what they do, and what effect those actions will have.

Mentalization based therapy (MBT) ((BATEMAN, ANTHONY, and PETER FONAGY. “Mentalization Based Treatment for Borderline Personality Disorder.” World Psychiatry, vol. 9, no. 1, Feb. 2010, pp. 11–15. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816926/.)) teaches people how to mentalize in a balanced way. Studies prove MBT can reduce the symptoms of BPD ((Vogt, Katharina Sophie, and Paul Norman. “Is Mentalization‐based Therapy Effective in Treating the Symptoms of Borderline Personality Disorder? A Systematic Review.” Psychology and Psychotherapy, vol. 92, no. 4, Dec. 2019, pp. 441–64. PubMed Central, https://doi.org/10.1111/papt.12194.)) and other mental health conditions. Empathy is especially hard for people with narcissistic personality disorders, ((Gabbard, Glen O., and Holly Crisp‐Han. “The Many Faces of Narcissism.” World Psychiatry, vol. 15, no. 2, June 2016, pp. 115–16. PubMed Central, https://doi.org/10.1002/wps.20323.)) so mentalization is an important skill to learn in treatment.

In MBT, patients practice mentalization during both group and 1:1 sessions. You might use specific events from your real life as examples. You’ll describe a situation—say, a recent argument with a friend. And your therapist will help you imagine how your friend might have felt. They’ll also help you identify and regulate your own feelings. These skills can improve your relationships with other people, and with yourself.

Medication Can Manage Symptoms

Currently, there are no medications specifically designed to treat personality disorders. ((“What are Personality Disorders?” American Psychiatric Association (APA). https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders)) Despite this, your doctor might recommend a prescription to control your symptoms. Antidepressants and mood stabilizers are common treatments. But it’s important to note that personality disorders aren’t purely neurochemical. ((Ma, Guorong, et al. “Genetic and Neuroimaging Features of Personality Disorders: State of the Art.” Neuroscience Bulletin, vol. 32, no. 3, Apr. 2016, pp. 286–306. PubMed Central, https://doi.org/10.1007/s12264-016-0027-8.)) On the contrary, experts think some of them may have environmental causes. As a result, it’s unlikely that medication alone will “fix” your personality disorder. You might also need to make some major behavioral changes. These complex conditions can impact every aspect of your life.

What Is a Personality Disorder?

Personality disorders affect more than your thoughts and feelings ((Personality Disorders: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000939.htm. Accessed 11 Dec. 2022.))—they also impact relationships. Even though they’re highly stigmatized, almost 10% of adults in the U.S. have a personality disorder. ((“Personality Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/statistics/personality-disorders. Accessed 11 Dec. 2022.))

People with personality disorders have intense emotions, ((Fariba, Kamron A., et al. “Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556058/.)) which can lead to unhealthy behaviors. Your mental health may interfere with your relationships, schoolwork, career, and more. And because people with personality disorders are so sensitive to stress ((“Personality Disorder.” Mental Health America, https://www.mhanational.org/conditions/personality-disorder. Accessed 11 Dec. 2022.)) that adversity can make your symptoms worse.

There’s some debate about when these conditions develop. Some experts say that personality disorders appear in adolescence. ((Adshead, Gwen, et al. “Personality Disorder in Adolescence.” Advances in Psychiatric Treatment, vol. 18, no. 2, Mar. 2012, pp. 109–18. Cambridge University Press, https://doi.org/10.1192/apt.bp.110.008623.)) Others describe symptoms during childhood. And some caution against diagnosis before patients reach adulthood. At any age, these are serious conditions.

Scientists categorize personality disorders into 3 different clusters:

Cluster A Personality Disorders

People with cluster A personality disorders ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) share a few traits. Most people with these conditions are socially withdrawn. You might actively mistrust the people around you, or you might just prefer solitude. You may also have a hard time expressing how you feel. Cluster A includes 3 diagnoses:

  • Schizoid personality disorder (ScPD): People with ScPD have a hard time showing emotion, and prefer to be alone most of the time. They rarely have relationships outside of family.
  • Paranoid personality disorder (PPD): The main characteristic of PPD is a distrust of others. This condition makes it hard to build or maintain relationships.
  • Schizotypal personality disorder (STPD): People with STPD may have strong superstitions, or think they have supernatural abilities. This often undermines relationships.

Cluster B Personality Disorders

People with cluster B personality disorders have intense emotions and low impulse control. This can make it hard for anyone—including them—to predict their behavior. As a result, they often have a pattern of unstable relationships. There are a few different Cluster B personality disorders:

  • Antisocial personality disorder (ASPD) describes people who don’t conform to social norms. In particular, they may disregard other people’s safety. People with ASPD often engage in risky activities, like high-risk sexual behavior or drug abuse. They generally lack remorse for this behavior.
  • Borderline personality disorder (BPD) involves a pattern of instability in relationships, self-image, and identity. People with BPD are highly emotionally sensitive.
  • Narcissistic personality disorder (NPD) ((Mitra, Paroma, and Dimy Fluyau. “Narcissistic Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556001/.)) occurs in 2 types. Grandiose NPD includes an inflated sense of self, boldness, and sometimes aggression. Vulnerable NPD appears as hypersensitivity and defensiveness.
  • Histrionic personality disorder (HPD) includes attention-seeking behavior and emotional sensitivity. People with HPD place a lot of value on their reputation and physical appearance.

Much of the stigma around personality disorders comes from a misunderstanding of cluster B diagnoses. As a result, finding treatment for cluster B disorders might be the most difficult. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) But at the same time, a great deal of research on personality disorders focuses on cluster B types. ((Mitra, Paroma, and Dimy Fluyau. “Narcissistic Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556001/.)) That research proves recovery is common, even in the most severe cases.

Cluster C Personality Disorders

On the other hand, cluster C personality disorders have the most treatment options. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) For these patients, the healing process resembles recovery from anxiety or depression. That’s because cluster C usually includes anxious thought patterns. There are 3 cluster C personality disorders:

  • Avoidant personality disorder (AvPD) features strong feelings of inadequacy. People with AvPD are sensitive to criticism. They usually fear intimacy and connection with other people.
  • Dependent personality disorder (DPD) involves being highly submissive in relationships. DPD undermines confidence, making it hard to make decisions for yourself.
  • Obsessive-compulsive personality disorder (OCPD), centers on perfectionism and the need for control. People with OCPD are hyperaware of rules and social norms, but reluctant to ask for help. This condition is notably different from obsessive-compulsive disorder (OCD).

Experts continue to research new treatments for all 3 clusters of personality disorders. Despite that growing body of work, the cause of these conditions is largely unknown.

What Causes Personality Disorders?

Scientists have several theories about what causes personality disorders. ((Fariba, Kamron A., et al. “Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556058/.)) But they still need more data. Some experts theorize that biology might play a role in these conditions. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) For instance, ScPD has a similar biological cause as schizophrenia, which hints at a genetic link.

Meanwhile, other studies show that ASPD and BPD have a similar impact on brain chemistry. That could explain why both conditions interfere with impulse control.

Other experts believe that childhood trauma can cause personality disorders. For example, people with BPD are more than 3 times more likely to report childhood adversity. ((Porter, C., et al. “Childhood Adversity and Borderline Personality Disorder: A Meta-Analysis.” Acta Psychiatrica Scandinavica, vol. 141, no. 1, Jan. 2020, pp. 6–20. PubMed, https://doi.org/10.1111/acps.13118.)) And it’s not just BPD. Other personality disorders are linked to childhood traumas, ((“What Causes Personality Disorders?” Https://Www.Apa.Org, https://www.apa.org/topics/personality-disorders/causes. Accessed 11 Dec. 2022.
)) like physical and emotional abuse.

Not all the data supports this theory. According to some, childhood trauma “does not appear to be a key factor” in the development of personality disorders. ((Berenz, Erin C., et al. “Childhood Trauma and Personality Disorder Criterion Counts: A Co-Twin Control Analysis.” Journal of Abnormal Psychology, vol. 122, no. 4, Nov. 2013, pp. 1070–76. PubMed Central, https://doi.org/10.1037/a0034238.)) But they’re certainly linked to other diagnoses. For example, many people with personality disorders also experience addiction. ((“Personality Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/statistics/personality-disorders. Accessed 11 Dec. 2022.))

The Link Between Personality Disorders and Addiction

Researchers have identified a link between personality disorders and substance abuse. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) Specifically, addiction is more common in people with ASPD, BPD, and STPD than others.

Studies show that over 50% of people with BPD have a history of addiction. ((“An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders.” In Brief: Fall 2014, Volume 8, Issue 3. Substance Abuse and Mental Health Services Administration, Department of Health and Human Services. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4879.pdf)) And people with schizotypal personality disorder often have addictions ((Hasin, Deborah, et al. “Personality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders.” Archives of General Psychiatry, vol. 68, no. 11, Nov. 2011, pp. 1158–67. PubMed Central, https://doi.org/10.1001/archgenpsychiatry.2011.136.)) to cannabis and alcohol.

There’s also a complex relationship between antisocial personality disorder and addiction. ((Robins, L. N. “The Intimate Connection between Antisocial Personality and Substance Abuse.” Social Psychiatry and Psychiatric Epidemiology, vol. 33, no. 8, Aug. 1998, pp. 393–99. PubMed, https://doi.org/10.1007/s001270050071.)) Some experts believe one condition can cause the other. Others think that both ASPD and addiction develop in response to underlying issues, like unresolved trauma. From that viewpoint, both conditions are ineffective coping strategies for untreated symptoms. And working through those symptoms might help you recover.

High-risk behavior, including self-harm, is associated with several personality disorders. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) In other words, addiction can be a symptom. But that’s not always the case. Some people use drugs to cope with other symptoms of their personality disorders. For instance, many people with AvPD have intense social anxiety. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) And, whether or not you have AvPD, there’s a clear link between social anxiety and alcohol abuse.

If you or a loved one is at risk of self-harm, you can get help right away. Call The National Alliance on Mental Illness HelpLine at 1-800-950-6264 or text “HelpLine” to 62640.

If you have these co-occurring disorders, it’s important to treat both at the same time. Your personality disorder might make recovery more complex. But with the right treatment, you can learn to manage your symptoms with healthier coping skills.

Recovery and Remission From Personality Disorders

Untreated personality disorders can impact every area of your life. Serious symptoms can interfere with your mental health, work, relationships, and dreams for the future. But it’s important to note that many of these symptoms are behavioral. And by learning better behaviors, you can heal both your symptoms and their underlying causes. With the right types of ongoing care, it’s even possible to go into complete remission.

To start recovery, browse our rehabs that treat personality disorders and learn more about their pricing, locations, and different types of therapy.

Reviewed by Rajnandini Rathod

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Nourishing the Recovering Body: Nutrition in Rehab

Eating well is a huge part of feeling well. Food doesn’t just support wellness—it can also be a source of joy. When you go to rehab for addiction or mental health treatment, great meals can be the thing you look forward to.  

Food is both a source of pleasure and an important tool for long-term recovery. Addiction and chronic stress deplete your body and compromise its ability to absorb nutrients. That’s why it’s crucial for your treatment plan to include healthy meals. And in some rehabs, nutrition is a major part of the program. 

Nutrition and Addiction

Addiction takes a toll on the body and mind. As the experts at Siam Rehab know, “if your body is healthy, you have a healthy mind with it as well.” Healing—both physically and mentally—starts by learning how addiction affects your eating habits.

How Substance Use Depletes Nutrients

Malnutrition is common among people with addiction.1 While you’re actively using, drugs and alcohol might be a higher priority than your diet.2 In some cases, drug use can even damage the organs that absorb nutrients. Different types of addiction have different effects on the body:

Diet During Detox and Withdrawal

When you’re ready to recover, detox is often the first step. You can expect this process to have immediate physical and emotional effects. For example, you may have digestive symptoms during withdrawal,8 like nausea, stomach pain, and a reduced appetite. Eating well supports your body’s natural healing abilities. 

Eating Well in Early Recovery

Drug cravings are a normal part of early sobriety. Food cravings might be, too. Data shows that your appetite can increase in your first 6 months of sobriety.9 You may even have more of a sweet tooth than usual. As a result, weight gain is common during inpatient rehab.10

For some clients, weight gain and body image become mental health issues. Gaining weight can even be a trigger for relapse.11 And experts believe that women in particular “increasingly report weight-related concern as motivation for drug use.” Some people even develop disordered eating habits during treatment.12 Without proper medical care, these issues can work against your long-term physical and emotional health.

With the right treatment, food can support your recovery—not undermine it. Eating balanced meals and learning about nutrition can help you heal from addiction.13 Plus, most people’s cravings and appetites return to healthy levels 6 months into addiction recovery.14 That’s especially likely for people who use structured eating plans. 

Food as Aftercare and Relapse Prevention

Good nutrition is important in every stage of recovery—even after you complete treatment. Eating well improves your physical health, of course. But that’s just the beginning. Poor eating habits also increase your risk of relapse.15 Studies link good nutrition with ongoing sobriety,16 overall mental health.

Nutrition and Mental Health

Balanced meals are a powerful way to boost your mood.17 As nutritional therapist Julia Ross writes, “this is the law of malnutrition: when your food quality or quantity deteriorates, your mood is the first casualty, even before your physical health begins to deteriorate.” Ross and many other experts report a link between food and emotional well-being.

The Gut-Brain Axis

There’s a direct line of communication between your gut and your brain.18 Experts call this the “gut-brain axis,” and it’s key to your mental health. Gut health impacts your mood, “motivation, and higher cognitive functions.”

Stress and changes in diet can affect digestion19 by harming the bacteria in your gut. That can cause a range of issues, from inflammation to leaky gut syndrome. Researchers have linked these conditions with depression and anxiety. On the other hand, several studies show that healthy digestive bacteria can improve your mood.20 

Eating Right for Your Brain

Studies indicate that people with certain mental health issues are very likely to have nutrient deficiencies.21 Those with depression, bipolar disorder, and obsessive-compulsive disorder are especially vulnerable. But, research also found that patients’ mental health improved when they took certain supplements. 

If you have any of these diagnoses, you can talk to your doctor or nutritionist to learn more. Make sure to get an expert opinion before taking any over-the-counter supplements. They may interact with other medications, or impact other parts of your recovery plan. 

Eating Disorders

If you’re healing from an eating disorder, good nutrition is a vital part of recovery. Because these conditions change your eating habits, they often damage your physical health. The exact risks vary, depending on your specific symptoms. 

Most eating disorder treatment programs include nutrition education,22 meal planning, and therapeutic meals. These activities bolster your skills around healthy eating, and give you the nutrition you need to fuel physical and emotional recovery. 

Studies show a strong connection between eating disorders and the need for control.23 This can make it feel especially scary to enter a treatment control. But, by learning to trust a team of professionals to help you heal, you’re working to take back control of the rest of your life. And good nutrition can empower you to do the hard work of building better habits.

Improve Your Energy and Clarity

Recovery takes effort. And in the early stages of treatment, you might not be used to keeping a strict schedule. You’ll also be working through heavy emotional issues, which can be tiring. Good nutrition boosts your energy and improves mental stamina, helping you focus on treatment. Certain nutrients are especially important for regulating energy and preventing fatigue:24

  • complex carbohydrates
  • fats
  • minerals like iron, magnesium, and zinc
  • vitamins like B vitamins and vitamin C

Because of the link between addiction and poor diet, eating well might feel like a big change when you enter rehab. This is also an issue during mental health treatment. For instance, studies show a link between depression and low vitamin levels.25 

Your mental health can impact your dietary requirements, and vice versa. But everyone’s needs are different. Your care team may advise a meal plan, IV therapy, or even fasting. Ask your admissions team about their approach to nutrition, and how that will impact your treatment plan. 

How Do Rehabs Provide Proper Nutrition?

Because nutrition is such a large part of both recovery and everyday life, it can affect every aspect of rehab. Every center has its own way of integrating nutrition into the healing process. 

In-House Nutrition Experts

Some rehabs employ nutrition specialists or other food experts. For example, you might work closely with a nutritionist or dietitian. These specialists create balanced meal plans, which they can tailor to meet each client’s needs. They may also give you vitamins, minerals, or other supplements. And when talented chefs design the daily menu, you can look forward to every meal. 

At Soberman’s Estate, a men-only rehab in Arizona, culinary excellence is a big part of the healing process. Using local ingredients from their on-campus greenhouse, their executive chef creates meals that are “as good as or better than most five-star restaurants,” as one previous patient said. 

If you have a refined palate, dietary restrictions, or other food-related needs, talk to your rehab’s admissions team about their ability to accommodate you. 

Designing Your Meal Plan

Addiction and mental health issues affect everyone’s body differently. Some rehabs create individualized meal plans to bring your body back into balance. They may take a blood test as part of your initial screening to see what nutrients you’re lacking, then work to remedy that throughout your stay. 

At Istana, a 1:1 rehab with locations in Bali, Barbados, and Ibiza, menus are designed to “address deficiencies in your diet and strengthen your body’s nutrition.” Each meal plan is designed by their team of professionals to meet clients’ unique dietary needs.

You’ll also have regular check-ins with the nutritionist to track how your body responds to meals throughout treatment. They can then make changes based on real-time feedback. By taking part in this process, you’ll learn about your own evolving needs and practice listening to your body. And when you leave the center, you’ll be more empowered to eat healthy and respond to your body’s needs.

Planning for Long-Term Recovery

Recovery doesn’t end when you leave rehab. Many centers offer nutrition education, so you can learn life skills before finishing treatment. This helps clients make long-term plans for their ongoing nutritional health. 

You can continue to benefit from proper nutrition on your own after learning about balanced eating from professionals. Inpatient treatment centers like Paracelsus Recovery in Switzerland help you set up long-term nutrition plans. These aren’t fads or quick fixes. Instead, they’ll show you how to care for your body and mind sustainably, using food as a tool.

Some centers even help find support for you closer to home in your aftercare. Rowland Tweedie, the center’s Health and Fitness Manager, explains, “I often try to find a local person that [clients] can be supported by: a personal trainer or nutritionist. Someone locally they can go to, to help them maintain or reinforce what they’ve been doing during the program.” 

Find Joy in Nourishing Your Body

Recovery isn’t just about moving away from unhealthy habits. It’s also about learning how to enjoy your life in a healthy way. And for many people, food can be a positive, healthy way to find that joy. Eating a tasty, nourishing meal can be a source of pleasure, no matter what else you’re dealing with.
Explore our searchable list of rehabs and filter your search by dietary preference, see centers that offer gourmet dining, and more.

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But What if I Relapse?

If you’re healing from addiction, it makes sense to worry about relapse. This can be a concern at every stage of recovery, whether you’re just starting detox or years into sobriety. Cravings and triggers don’t just disappear. But with the right type of addiction treatment, you can make a plan to keep yourself safe.

Notice the Warning Signs

Everyone’s triggers are different. And in recovery, you’ll learn to recognize and work through them as they arise. Some of them you can simply avoid—like going to the bar, or missing a night of sleep. Others are inescapable. But because these situations are so common, you can often see them coming. And that foresight can help you navigate them more skillfully.

Stress

Stress is a natural part of life. And that’s not always a bad thing. Even positive events can be stressful, ((Why stress and anxiety aren’t always bad. (n.d.). Https://Www.Apa.Org. Retrieved October 27, 2022, from https://www.apa.org/news/press/releases/2019/08/stress-anxiety)) like buying a new car or planning a wedding. You can’t avoid all big changes—and you shouldn’t try to. But you can manage your emotional response to them.

As you return to life after treatment, try to be gentle with yourself. Data shows that people with addiction are more vulnerable to stress. ((Stocker, S. (1999). Studies Link Stress and Drug Addiction. The Science of Drug Abuse and Addiction Research Findings, 14(1). https://web.archive.org/web/20170829165640id_/https://www.centerforaddictionrecovery.com/stress/Studies-Link-Stress-and-Drug-Addiction-NIDA.pdf)) And what’s more, unmanaged stress can increase your risk of relapse. ((Sinha R. (2012). How does stress lead to risk of alcohol relapse?. Alcohol research : current reviews, 34(4), 432–440. Retrieved October 27, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788822/)) That’s why it’s important to have a plan for how you’ll handle these situations when they come up.

According to experts, emotion regulation skills can help you get through stressful situations. ((Langer, K., Hagedorn, B., Stock, L.-M., Otto, T., Wolf, O. T., & Jentsch, V. L. (2020). Acute stress improves the effectivity of cognitive emotion regulation in men. Scientific Reports, 10(1), 11571. https://doi.org/10.1038/s41598-020-68137-5
)) You can learn these skills in rehab or from a therapist, and practice them on your own. For example, you might meditate, do breathing exercises, or try other mindfulness techniques. These coping strategies can keep you centered during intense moments.

Trauma

Even in times of stability, you might be distracted by painful memories. And unprocessed trauma is linked to addiction. ((Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751)) This is true whether it occurred in childhood, in recent years, or as a result of drug use. Working with a trained therapist can help you move forward, but it won’t undo the past. You may still confront triggers from time to time. When that happens, you can use skills to work through your emotional response.

Addiction is a common response to trauma. ((Schneiderman, N., Ironson, G., & Siegel, S. D. (2005). Stress and health: psychological, behavioral, and biological determinants. Annual review of clinical psychology, 1, 607–628. https://doi.org/10.1146/annurev.clinpsy.1.102803.144141
)) Taking drugs can make you feel like you have control of your own mind, even though the opposite is true.  And if you’ve ever used drugs to deal with trauma, you might be more likely to fall back on that behavior. Scientists have established a clear link “between craving, relapse, and PTSD symptoms.” ((Gielen, N., Krumeich, A., Tekelenburg, M., Nederkoorn, C., & Havermans, R. C. (2016). How patients perceive the relationship between trauma, substance abuse, craving, and relapse: A qualitative study. Journal of Substance Use, 21(5), 466–470.))

Traumatic memories and events might always trigger your cravings. But in trauma-informed rehab, you’ll learn coping skills that work better than drug use. And when you put those skills to use, it’s more than damage control. It can also be empowering.

Know Your Triggers

Recovery from almost anything is the process of getting to know yourself again. That’s true for addiction, mental health issues, trauma, and even some physical conditions. Maybe your energy levels are different, or you have new needs and boundaries. Maybe you want to pick up different hobbies, or restructure your relationships. There’s no wrong answer, as long as you stay present, honest with yourself, and focused on living a healthy life.

Understanding your own triggers is a big part of this process. And triggers aren’t always easy to predict or even explain. If you were once in a car crash, you might be triggered by loud noises or getting stuck in traffic. But you can also be triggered by relationship dynamics, sensations, and even emotions.

Learning to anticipate triggers and cravings can be confusing at first. But over time, it becomes intuitive. The first step is just paying attention to your own emotional reactions. Then, you can discuss your feelings with your therapist or another provider. With this information about your own impulses, you can start planning healthy ways to respond.

Guard Against Relapse by Planning Ahead

From the moment you enter rehab, your team will help you prepare for the risk of relapse. During treatment, you’ll amass resources and coping strategies to help you guard against it. And if you do relapse, you’ll already have a plan for what comes next.

Build an Emotional First-Aid Kit

Cravings aren’t convenient. They won’t always happen in the comfort of your home, or when you’re about to have a day off. In fact, because of the link between relapse and stress, you might be at a higher risk while you’re doing something important.

When you’re already feeling stressed, it can be hard to think clearly. That’s why some people in recovery make emotional first-aid kits. Your kit can take any form, from an actual first-aid kit to a post-it note to an art project. Just make sure it’s easily accessible, and has genuinely helpful information. You can start by including a few standard resources:

  • a list of activities that help you calm down, like exercising or playing games
  • a list of distress tolerance skills you find helpful, like breathing exercises or listening to a song you love
  • a comfort object, like a soft pillow or a worry stone
  • a copy of your favorite book
  • a mantra you can repeat to yourself during meditation
  • the phone numbers for trusted contacts, like your therapist, your sponsor, or your best friend

Connect With Your Community

Strong relationships decrease the risk of relapse. ((Ellis, B., Bernichon, T., Yu, P., Roberts, T., & Herrell, J. M. (2004). Effect of social support on substance abuse relapse in a residential treatment setting for women. Evaluation and Program Planning, 27(2), 213–221. https://doi.org/10.1016/j.evalprogplan.2004.01.011)) And you can start building your support network as soon as you enter recovery. That could mean meeting new people, or recommitting to loved ones. In many programs, you can even do family therapy during rehab.

Your support system can include several different types of relationships. Friends, family, and chosen family members are a great place to start. But you can also join more formal communities. Both 12-Step and non-12-Step groups  (like SMART Recovery groups) offer peer support. In these meetings, you can share your concerns about relapse with people who likely feel the same way.

When people expect things from you, they’ll hold you accountable. This even applies to low-stakes situations. If you miss a friend’s birthday party, they might ask if you’re ok. In the long term, these gentle nudges can help you stay on track. And, after you build trust over time, you’ll have people to lean on in crisis situations.

Stick With (or Revisit) Your Continuing Care Plan

Personal relationships are essential, but they’re just one piece of the puzzle. While you can ask friends for emotional support, you can’t depend on them for clinical treatment. It’s important to find a team of mental health providers who can see you through recovery.

If you attend residential rehab, you can start planning for aftercare during treatment. In some cases, you can continue seeing the same therapist after you return home. But most of the time, you’ll need to look for a new one. You might also find other specialists, like a psychiatrist or a medical doctor who understands addiction.

These experts can help you plan ahead. They might notice behavioral warning signs, and suggest you take action even before you relapse. And if you’re in crisis, they can connect you with valuable resources, and help you focus on healing.

Responding to Relapse

Relapse happens. Healing is complex, even if you have great coping skills. And your path toward recovery might not be a straight line. And that’s okay.

If you do relapse, it’s important to face the issues behind it. Shame and addiction are related, ((Matthews, S., Dwyer, R., & Snoek, A. (2017). Stigma and Self-Stigma in Addiction. Journal of bioethical inquiry, 14(2), 275–286. https://doi.org/10.1007/s11673-017-9784-y)) and hiding your problems can exacerbate them. Instead, it’s best to find help as soon as you can. Reach out to your support network and your care team to let them know what’s happening. You can also call your original treatment center and ask them for advice.

Depending on your circumstances, you might need to kickstart recovery again. This could mean going through detox, returning to rehab, or trying something new. Your mental health provider can help you decide on the best way to move forward.

Recommitting to the Recovery Journey

Whatever comes after relapse, you can rely on one thing: you won’t be starting from scratch. Even this bump in the road is a step toward recovery. Relapse gives you important information about your triggers, needs, and recovery goals. And you can use that information to make even better choices about what comes next.

See our searchable directory of rehabs to get support at any stage of recovery, from detox to continuing care.

Reviewed by Rajnandini Rathod

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What Happens When You Get Sober?

When you’re living with an addiction, it can be hard to imagine recovery. Many people get lost in the negative, thinking about life without drugs or alcohol. But what about life with more time, energy, and emotional stability?

Addiction eats away at your resources. People lose money, relationships, their physical health—the list goes on and on. When you start healing, you’ll have so much more to work with. If you decide to attend a residential treatment center, experts can help you put those assets to use. And from there, you’ll start dreaming of—and planning for—a better future.

1. Your Mental Health Gets Better

Addiction affects both your physical and mental health. ((Addiction and health. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health)) And when you’re actively using drugs, the idea of withdrawal might sound even worse. That’s a valid fear. But it might not be a reality. With the right support, detox doesn’t have to be dangerous. Best of all, withdrawal and detox are temporary. And unlike continued substance use, they offer a lot to look forward to on the other side.

Focus More Easily

Addiction makes it hard to focus, ((Gould, T. J. (2010). Addiction and cognition. Addiction Science & Clinical Practice, 5(2), 4–14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120118/)) reason, and learn new things. It can also interfere with your memory. This is because drugs quite literally change your brain. You might not even notice these issues at first, since they start so gradually. But shortly after getting sober, you can expect your mental state to improve. ((Module 10: Sobriety Sampling. (n.d.). Boston Center for Treatment Development and Training. https://www.mass.gov/doc/module-10-sobriety-sampling-0/download))

Manage Co-Occurring Symptoms

Studies show that 50% of people with addiction also have a mental health condition. ((Part 1: The connection between substance use disorders and mental illness. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness)) Because of this, many rehabs treat co-occurring disorders.

In these programs, you’ll learn how to manage your conditions in a healthy way. You may even find that just one type of treatment helps you heal from both addiction and another health issue. ((Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current status of co-occurring mood and substance use disorders: A new therapeutic target. The American Journal of Psychiatry, 170(1), 23–30. https://doi.org/10.1176/appi.ajp.2012.12010112))

2. Your Physical Health Improves

Addiction takes a serious toll on your body, as well as your mind. And before treatment, you may not even be aware of all your physical symptoms. Most rehabs can treat these issues alongside your mental health. And during recovery, your health may start to improve in some unexpected ways.

3. You Kickstart a Healthy Lifestyle

There’s more to recovery than therapy. Even in rehab, you can engage in fun, fulfilling hobbies, like martial arts or cooking. These healthy coping tools can help you stay grounded after you complete treatment.

Sobriety can help you get your life on track in measurable, practical ways. Studies show that most people’s finances improve during addiction recovery. ((Laudet, A. (2013). Life in Recovery [Report on Survey Findings]. Faces and Voices of Recovery. https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/22Life-in-Recovery22-Report-on-the-Survey-Findings.pdf)) And that, in turn, can improve your mental and even physical health. Experts agree that financial stability decreases your chance of depression, ((Bialowolski, P., Weziak-Bialowolska, D., Lee, M. T., Chen, Y., VanderWeele, T. J., & McNeely, E. (2021). The role of financial conditions for physical and mental health. Evidence from a longitudinal survey and insurance claims data. Social Science & Medicine, 281, 114041. https://doi.org/10.1016/j.socscimed.2021.114041)) anxiety, and heart disease. This solid foundation can empower you to take healthy risks, like meeting new people.

4. You’ll Build a Sober Community

Sobriety can improve your relationships. ((Kemp, R. (2019). Addiction and addiction recovery: a qualitative research viewpoint. Journal of Psychological Therapies. 4. 167-179. https://www.researchgate.net/profile/Ryan-Kemp-3/publication/337410578_Addiction_and_addiction_recovery_a_qualitative_research_viewpoint/links/5e54e278299bf1bdb8395e12/Addiction-and-addiction-recovery-a-qualitative-research-viewpoint.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail)) Many residential programs are built to support this.  In rehab, you’re surrounded by people who support your healing goals. And once you start to repair your relationship with yourself and others, you’ll get to build a support network that has your back as you continue your journey.

This new community can be found through 12-Step meetings, non-12-Step support groups, sober living, or outpatient aftercare. Or, you could connect with people who share your interests. Whether you find a new hobby or pick up an old one, this can be a fun, low pressure way to find like-minded people.

If your previous social circle was built around drug use, this is your chance to form new, healthy relationships. And because forming social connections with other sober people can help prevent relapse, ((Study shows impact of social interactions on addictive behavior. (2018, October 15). National Institute on Drug Abuse. https://nida.nih.gov/news-events/news-releases/2018/10/study-shows-impact-of-social-interactions-on-addictive-behavior)) it’s an important part of your recovery.

5. You Have the Chance to Reconnect With Loved Ones

Addiction damages close relationships ((Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work in Public Health, 28(0), 194–205. https://doi.org/10.1080/19371918.2013.759005)) with both given and chosen family. But recovery empowers you to hone your interpersonal skills. And, in time, those skills might help you heal your family dynamic.

For Michael Waggoner, sobriety is an opportunity to reconnect with family. ((Michael waggoner. (2020, September 9). Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/michael-waggoner/)) “I am rebuilding relationships with my family, I am rebuilding trust,” he says. “I am able to be a dad today and a positive influence in my son’s life.”

6. You Can Realize Your Higher Purpose

Experts say that “addiction is a response to boredom, loneliness, meaninglessness, and other existential struggles.” ((Thompson, G. R. (n.d.). Meaning Therapy for Addictions: A Case Study. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1026.5596&rep=rep1&type=pdf)) Sobriety can help you find your purpose, and go on to live a meaningful life. Instead of just coping with a series of problems, you can build confidence and start moving toward the future you want for yourself.

When he was addicted to alcohol, James Gibbon had “no hope for the future.” ((James gibbons. (2020, September 9). Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/james-gibbons/)) He faced  legal, financial, and relationship problems as a result. “I accepted the fact that I would never own a home, have a career, graduate from college, meet somebody special, and start a family,” he says. But after treatment:

“I began to see potential in myself. My confidence began to grow.”

The hard work of recovery can help you resolve past trauma, and teach you healthier coping strategies. With those skills, James achieved all the goals he thought were beyond him. And that isn’t unusual. When you stop using drugs and enter recovery, your potential for success only grows.

Sobriety Is Just the Beginning

It takes hard work to get and stay sober.

Healing isn’t just about stopping drug use. It’s about starting a new chapter.

And once you commit to recovery, you might be surprised by your own strength. That self-confidence is a powerful starting point.

Visit our directory of inpatient rehabs to learn more about their locations, services, pricing, and more.

Reviewed by Rajnandini Rathod

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Resources for Healing From Borderline Personality Disorder

Borderline personality disorder (BPD) is hugely stigmatized, and not well understood by the general public. There are many resources for the loved ones and family members of people with BPD. But if you’re the one living with this condition, it can be hard to get the help you need—and deserve.

BPD is a serious mental illness, not a personal failing. You are not to blame for your symptoms. That said, you are responsible for your own recovery process. It’s not all on you, though. You can and should get expert support. You might even attend rehab for BPD. And even before you start treatment, these resources can empower you to start healing.

What Is BPD?

As the name says, BPD is in a class of mental illnesses termed “personality disorders.” But, according to psychiatric researchers at Monash University, the name is harmfully inaccurate. “Rather than as a personality disorder,” they write, “BPD is better thought of as a complex response to trauma. ((Kulkarni, J., & Walker, P. (n.d.). We need to treat borderline personality disorder for what it really is – a response to trauma. The Conversation. Retrieved September 23, 2022, from http://theconversation.com/we-need-to-treat-borderline-personality-disorder-for-what-it-really-is-a-response-to-trauma-115549)) It’s time we changed its name.”

BPD is defined by 9 diagnostic criteria. ((Biskin, R. S., & Paris, J. (2012). Diagnosing borderline personality disorder. CMAJ : Canadian Medical Association Journal, 184(16), 1789–1794. https://doi.org/10.1503/cmaj.090618)) If you exhibit 5 or more of these symptoms, you might have BPD. Unlike some other mental illnesses, a lot of the criteria are behavioral, and not just internal. For example, the first item on the list is “frantic efforts to avoid real or imagined abandonment.” Even with treatment, your fear of abandonment might never go away. But you can learn to manage that fear, instead of acting out and damaging your relationships.

This has powerful implications. In short, it means that it’s possible to recover from BPD. ((Biskin, R. S. (2015). The lifetime course of borderline personality disorder. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 60(7), 303–308. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500179/)) In one study, “slightly more than one-half the patients with BPD achieved recovery” in the long term. Experts note that there is always a risk of relapse. You may need ongoing therapy or other treatment to stay in remission. Wherever you are in your healing journey, you can use a variety of tools to support your mental health.

1. Workbooks for Recovery

There are several workbooks designed to help people living with borderline personality disorder. You can even go through some of these on your own. Others are more advanced, and can be very triggering if you don’t have expert support. Talk to your therapist about which ones are right for you, right now. As you work through these books, try to be gentle with yourself. You don’t need to move quickly, or prove you’re a “good student.” Instead, think about gradually integrating these ideas into your daily life. Move forward slowly and sustainably, instead of going so fast that you fall.

This book is a great introduction to recovery from borderline. It contains worksheets, case studies, and in-depth descriptions of the diagnosis. If you’ve just been diagnosed, these materials to learn about your recovery options.

Dialectical behavior therapy, or DBT, is a therapy designed to help people with BPD. DBT is structured like a class, with group sessions and homework assignments. You may also see a 1:1 therapist. This is the latest edition of the textbook that most DBT groups use. If you’re planning to start DBT soon, it might be helpful to flip through the book on your own beforehand. But don’t dive in too deep. Instead, wait for your therapist to guide you through the assignments.

This is an advanced workbook. If you’re already working with a therapist to treat your BPD, you can ask whether they think it would be helpful. The subject matter can be triggering, especially if you’re new to this diagnosis. But if you’ve been in recovery for some time, these insightful worksheets can take your healing process to the next level.

2. DBT Card Decks

With a therapeutic deck of cards, it’s easy to integrate mental wellness into your daily routine. Each deck contains bite-sized tips and activities, founded in a specific healing modality. You might try drawing a new card every morning, and thinking about it throughout the day. Or, you can keep the deck on hand, and shuffle through it whenever you need support. This format makes recovery more accessible, even on days when you don’t speak to your therapist.

This is a companion deck to the workbook by the same authors. It’s organized into 4 suits, which correspond to the 4 modules of DBT: ((Biskin, R. S. (2015). The lifetime course of borderline personality disorder. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 60(7), 303–308. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500179/)) mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Each card describes an activity you can do to practice your DBT skills.

This deck uses the same 4 modules of DBT, and it adds a 5th: Dialectics. In that suit, you’re asked to hold 2 opposing ideas in your mind at the same time. For example, one card reads: “Think about someone’s ideas or perspectives that are disagreeable to you. Now find the kernel of truth in those ideas or perspectives from that person’s vantage point. Is there a middle ground between the extremes?”

The second edition of Pederson’s DBT deck contains even more ideas and activities for people living with BPD.

3. Self-Help Books

If you learn best by reading, you might want to check out these books about mental health. And you don’t only have to read about borderline personality disorder. In fact, learning too much about BPD too fast can interfere with your healing process. A lot of information can be triggering, especially if it perpetuates stigma. If you’re just starting your recovery journey, they can wait. Instead, you might want to start with more practical guides to improving your daily life. And of course, if your therapist recommends you read more about BPD, there’s always more to learn.

Written by a psychotherapist, this book is based on the principles of acceptance and commitment therapy (or ACT, pronounced like the word “act”). Harris teaches that you can live a meaningful life when you stop trying so hard to be happy. The pressure to achieve some imaginary goal can actually get in your way. You’ll also learn about mindfulness exercises, which can be especially helpful for people for people with BPD.

There’s a difference between codependency and borderline personality disorder, ((Dependency, codependency, and bpd(Borderline personality disorder). (n.d.). Retrieved from https://www.youtube.com/watch?v=kW1_8pBmkXE)) but they often co-occur. According to BPD specialist Dr. Daniel Fox, ““Those with BPD are at a high likelihood to have dependency and codependent traits.” This book is considered the gold standard for recovery from codependency. But it’s rooted in the principles of 12-Step recovery, which aren’t a great fit for everyone. Specifically, the author writes from a spiritual perspective, often referencing a Christian higher power. The practical tools in this text might still be helpful, even if you don’t share those beliefs.

4. Positive Media Representation of Borderline Personality Disorder

It can be hard to find respectful representations of people with borderline. And there are all too many movie villains who exhibit BPD symptoms. When you’re entering recovery, it’s best to avoid these harmful narratives. Fortunately, there are a few examples of main characters who are actively trying to heal from this serious condition.

Don’t let the title fool you. In fact, the writers use it as a tool to highlight the stigma against BPD. The main character, Rebecca Bunch, often talks about how hurtful it is to be referred to this way. The series begins before her diagnosis, and follows her through a mental health crisis and early recovery. Critics agree that Crazy Ex-Girlfriend is a deeply empathetic look at life with borderline personality disorder. This is a fictional portrayal of BPD, and it certainly won’t resonate with everyone. (Especially if you don’t like musical theater.)

In her memoir, Gelder fearlessly confronts some common experiences of people with BPD. First, she describes the instability of life before her diagnosis. Her healing journey is non-linear, with bouts of therapy, remission, and relapse. Her self-compassion may be inspiring for people just starting to think about recovery.

5. Finding the Right Therapist

Therapy is an essential part of healing from many mental illnesses. Borderline is no exception. And since BPD is often related to childhood trauma, ((Bozzatello, P., Rocca, P., Baldassarri, L., Bosia, M., & Bellino, S. (2021). The role of trauma in early onset borderline personality disorder: A biopsychosocial perspective. Frontiers in Psychiatry, 12. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.721361)) healing can be complex. While you’re learning new skills, you may also have to work through painful memories. But with the right support, healing can be empowering—and even joyful.

Not every therapist is qualified to treat people with BPD. If you’re just getting started, look for a provider with experience in some of these areas:

  • Dialectical behavior therapy (DBT) is an extremely common way to treat borderline personality disorder. Classic DBT combines group and individual sessions. But a therapist might be trained in these techniques even if they only offer 1:1 therapy.
  • Mindfulness can be very helpful for people healing from BPD. In fact, DBT is based on the principles of buddhism.
  • Trauma-informed care is designed to treat people with PTSD, c-PTSD, or just a history of trauma. Since there’s so much overlap between BPD and trauma, this approach might be a good fit for people with this condition.

Living Well, With BPD

If you have BPD, it’s important to take your recovery seriously. With the right support, you can absolutely go into remission. And you can go on to live a full and meaningful life. In time, the criteria for this diagnosis might not even fit you any more.

But healing isn’t simple. And a lot of your work in therapy will center around learning to accept contradictions. One of these is: you are doing your best, and you can learn to do better. Living well is hard work, but it’s worth it. And there are plenty of resources to help you get started.

Reach out to a rehab center that treats BPD to learn more about their types of therapy, pricing options, aftercare programs, and more.

Reviewed by Rajnandini Rathod